Combination of Topiramate in Acute Mania

Yoon, Bo Hyun; Bae, Seung Oh; Yoon, Jin Sang; Lee, Kyung Loun; Choi, Young

Abstract

OBJECTIVE
The rapid therapeutic action of mood stabilizers is critical to the initial management of acute mania, because it enables to minimize the psychological sequelae of the patients commonly occurred in post manic episodes and to increase the compliance to the medications. The aim of this study was to evaluate the efficacy and safety of topiramate as the combination regimen in the treatment of acute mania.
METHODS
Twenty manic patients were selected through various screening tests. Ten patients were randomly assigned to valproate alone and the other ten patients to the combination of topiramate and valproate. Antipsychotics were not allowed and benzodiazepines were available as needed. Young Mania Rating Scale (YMRS) and Clinical Global Impression severity of illness scores (CGI-S) were used to evaluate the improvement of manic symptoms at pre-drug baseline and at 1st, 2nd, 4th and 8th week of post-drug. UKU side effect rating scales were done for assessment of drug-induced side effects. Additionally, body weights were checked at weekly basis to monitor the weight change. Repeated measures ANOVA was done to compare the effects between two groups.
RESULTS
YMRS of topiramate combination groups were significantly decreased at 1st, 2nd weeks. There were no marked differences in side effects. There was significant weight decrease in topiramate combination group whereas the increase of weight in valproate alone group.
CONCLUSION
The results suggest that the combination of topiramte may be used effectively and safely in treatment of acute mania and can be the good choice in manic patients with weight problem.